POS1318 GASTRO-INTESTINAL INVOLVEMENT IN SYSTEMIC SCLEROSIS: IMPORTANCE OF AN EARLY DIAGNOSIS THROUGH POPULATION SCREENING AND THE “UCLA SCTC GIT 2.0” QUESTIONNAIRE
Authors: F. R. Di Ciommo, A. Ulian, G. Pellegrino, D. M. Reza Beigi, I. Bisconti, M. Cadar, S. Truglia, C. Severi, F. Conti, V. Riccieri
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Gastrointestinal tract (GIT) involvement in Systemic Sclerosis (SSc), often identified late or sometimes unacknowledged, is estimated in nearly 90% of patients and can be severe in more than 10% of them. "UCLA SCTC GIT 2.0" is a validated questionnaire to assess GI symptoms, using a total score between 0 and 2.83. <h3>Objectives</h3> We aimed to study the role of "UCLA SCTC GIT 2.0" questionnaire in the outpatient practice, as a tool to optimize the diagnosis of GIT disorders and to characterize the specific manifestation for each patient. We also investigated the GIT prevalence in our population to identify predictors of more severe involvement. <h3>Methods</h3> We carried-out a prospective study in patients with SSc, according to the 2013 ACR/EULAR criteria, attending our "Scleroderma Clinic". GIT involvement was investigated through history and administration of "UCLA SCTC GIT 2.0" questionnaire. Patients were stratified according to the severity of 6 items (gastroesophageal reflux disease-GERD, distension/bloating-D/B, fecal incontinence, bowel movements such as diarrhea or constipation, social activities, emotional well-being) into 3 subgroups: "none to mild", "moderate", "severe to very severe". GIT involvement and its severity have been compared with clinical-demographic and laboratory features. <h3>Results</h3> Study population consisted of 87 patients (M/F 7/80), median age [IQR] of 64 [54;70] years. 81(93%) cases presented GIT disorders where GERD symptoms showed the highest prevalence followed by the B/D ones. The descriptive analysis of the main characteristics is summarized in Table 1. The "UCLA SCTC GIT 2.0" questionnaire revealed a median Total score [IQR] of 0.41 [0.21;0.84]. Median scores and trend of each item are reported in Figure 1. The median D/B score 1 was the statistically highest among all the other reported GIT scores (p=0.0030; p=&lt;0.0001; p=&lt;0,0001 respectively). The analysis of the collected data showed a positive association between GERD and D/B (r=0.4144; p=&lt;0.0001), while positive correlations were found for both total score and GERD with smoking habit (r= 0.2735; p= 0.0104) (r=0.2117; p= 0.0490) and with PPI therapy (r= 0.2270; p= 0.0345) (r= 0.2269; p= 0.0346) respectively. Diarrhea was positively associated with PPI treatment (r= 0.2765; p= 0.0095), while Total score (r= -0.2181; p= 0.0424), GERD (r= -0.2327; p= 0.0301), and diarrhea (r=-0.2386; p= 0.0261) were negatively associated with vascular therapy. D/B score was positively associated with the limited form of the disease (r= -0.2158; p=0.0447) but negatively with mRSS &gt; 7(r=-0.3067; p=0.0039) and disease duration (r=-0.2602; p=0.0149). We didn't find any correlation between GIT involvement and specific autoantibody presence. <h3>Conclusion</h3> Although the results of the present study confirm the higher prevalence of GERD in SSc, they also highlight the highest median score of D/B, often underestimated, whereas its negative correlation with the disease duration, rather than with the extension of the cutaneous involvement, seems to point at an early phenomenon not to be disregarded at the beginning of the patient follow-up. Of interest is to investigate the effective role of vascular therapy for GIT involvement. These findings underline that timely diagnosis and early treatment could provide the opportunity to implement clinical action as well as improvement in the GIT prognosis in SSc, encouraging wider and longer studies. <h3>Reference</h3> [1]Khanna D, Hays RD, Maranian P, Seibold JR, Impens A, Mayes MD, Clements PJ, Getzug T, Fathi N, Bechtel A, Furst DE. Reliability and validity of the University of California, Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument. Arthritis Rheum. 2009 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.